Clinical InvestigationAcute Ischemic Heart DiseaseEffect of marital status on the outcome of patients undergoing elective or urgent coronary revascularization
Section snippets
Methods
The study protocol was approved by the institutional review boards of MedStar Washington Hospital Center and the MedStar Health Research Institute. A dedicated data coordinating center performed all data management and analyses. Clinical observational analysis of consecutive patients on PCI from 2003 to 2011 was performed. Patients were divided according to their marital status, comparing married patients with unmarried patients. The unmarried group included single, divorced, and widowed
Results
A total of 11,216 patients who had elective or urgent PCI were included in the current analysis. The average age was 64 ± 12 years, 65% were men, 66% were white, and 26% were African American. Percutaneous coronary intervention was performed for stable angina pectoris in 3,085 patients (28%), for unstable angina in 5,097 (46%), and for acute MI in 1,498 patients (13%).
Among the total study population, 6,141 patients (55%) were married, whereas 5,075 (45%) were unmarried. Significant differences
Discussion
The major findings of the current study indicate that married patients who undergo urgent or elective PCI have superior short- and long-term outcomes up to 1 year when compared with unmarried individuals. These outcome benefits persist after adjustment for multiple traditional factors associated with outcome after PCI. Subgroup analyses of men and women indicated that both genders derived a similar benefit from being married.
Previous studies have shown conflicting results with regard to
Limitations
There are several limitations to our study. It was a post hoc analysis and, as such, is subject to the limitations of retrospective studies. Results may have possibly been affected by unknown confounders. Despite the high number of patients included, it is a single-center registry and unknown confounders may limit the general applicability of our findings. We did not subdivide the unmarried patients into subcategories such as single, separated, and widowed. However, there is a large body of
Conclusions
The present study provides evidence for a robust association between marital status of patients undergoing PCI and improved long-term outcomes up to 1 year. The advantage provided by marriage has independent effects for patients who undergo elective or urgent PCI. These findings are more pronounced in married men compared with married women. These findings should heighten awareness of physicians for socioeconomic risk factors beyond the standard cardiovascular disease risk factors and may
References (27)
- et al.
The protective effect of marriage on mortality in a dynamic society
Ann Epidemiol
(2007) - et al.
A longitudinal study of health selection in marital transitions
Soc Sci Med
(1998) - et al.
Marriage protection and marriage selection—prospective evidence for reciprocal effects of marital status and health
Soc Sci Med
(1996) - et al.
Comparison of outcomes of patients with myocardial infarction when living alone versus those not living alone
Am J Cardiol
(2002) - et al.
Does living alone affect the outcome of acute myocardial infarction?
Am J Cardiol
(2003) - et al.
Marital status and health among the elderly
Soc Sci Med
(1995) Gender, marital status and the social control of health behavior
Soc Sci Med
(1992)- et al.
Marital status and mortality: the national longitudinal mortality study
Ann Epidemiol
(2000) - et al.
Marital quality predicts hospital stay following coronary artery bypass surgery for women but not men
Soc Sci Med
(2006) - et al.
Social relationships and mortality risk: a meta-analytic review
PLoS Med
(2010)
Mortality differentials by marital status: an international comparison
Demography
Marital status and mortality in middle-aged Swedish men
Am J Epidemiol
Marriage selection and mortality patterns: inferences and fallacies
Demography
Cited by (26)
Does Marital Status Impact Outcomes After Total Knee Arthroplasty?
2016, Journal of ArthroplastyCitation Excerpt :The present study may have been underpowered to detect significant differences between groups using multivariate analysis. Considerably larger studies have shown that marital status is a significant independent predictor of treatment outcomes after controlling for the effects of potentially confounding variables [17-21]. For example, the Spine Patient Outcomes Research Trial, which enrolled 1244 patients who underwent discectomy or nonoperative management for disc herniation, found marital status to be a significant independent predictor of functional disability in a multivariable analysis [17].
Marital status and long-term cardiovascular risk in general population (Gubbio, Italy)
2023, Scientific ReportsComparisons of Patients Living Alone versus Living with Others in Acute Coronary Syndrome
2023, International Journal of Angiology